Individual
DR. DANA ELLYN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2400 47TH AVE, ROCK ISLAND, IL 61201-6964
(715) 255-2772
Mailing address
2400 47TH AVE, ROCK ISLAND, IL 61201-6964
(715) 255-2772
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
02120
IA
2251P0200X
Pediatric Physical Therapist
Primary
070-018070
IL
2251P0200X
Pediatric Physical Therapist
11006-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129630
CIGNA
IA
01
—
16843
WELLMARK
IA
01
—
F232191
MIDLANDS CHOICE
IA
Enumeration date
06/08/2006
Last updated
02/29/2012
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